Abstract. Malignant pleural mesothelioma (MPM) is a highly aggressive tumor with an extremely poor prognosis. The incidence of MPM is increasing as a result of widespread exposure to asbestos. The molecular pathogenesis of MPM remains unclear. The present study analyzed the frequency of various genomic copy number gains (CNGs) in MPM using reverse transcription-quantitative polymerase chain reaction. A total of 83 primary MPMs and 53 primary lung adenocarcinomas were analyzed to compare the CNGs of EGFR, KRAS, MET, FGFR1 and SOX2. In MPM, the CNGs of EGFR, KRAS, MET, FGFR1 and SOX2 were detected in 12 (14.5%), 8 (9.6%), 5 (6.0%), 4 (4.8%) and 1 (1.2%) of the samples, respectively. In lung adenocarcinomas, the CNGs of EGFR, KRAS, MET, FGFR1 and SOX2 were detected in 21 (39.6%), 12 (22.6%), 5 (9.4%), 10 (18.9%) and 0 (0.0%) of the samples, respectively. The CNGs of EGFR, KRAS and FGFR1 were significantly less frequent in the MPMs compared with the lung adenocarcinomas (P=0.0018, 0.048 and 0.018, respectively). Overall, the MPMs exhibited these CNGs less frequently compared with the lung adenocarcinomas (P=0.0002). The differences in CNGs between the two tumor types suggested that they are genetically different.
IntroductionMalignant pleural mesothelioma (MPM) is a tumor derived from the mesothelial cells lining the pleural spaces. MPM has highly invasive and aggressive clinical characteristics. Approximately 80% of MPM patients have a history of occupational asbestos exposure, which is considered to be a risk factor for the development of the disease (1). The molecular pathogenesis of MPM is not well understood. The most common mutations in MPMs are losses in 9p21, 1p36, 14q32 and 22q12, and gains in 5p, 7p and 8q24, which have been detected by comparative genomic hybridization analysis (2,3). Homozygous deletion of the 9p21 locus encoding two critical cyclin-dependent kinase inhibitors, p16INK4a and p15 INK4b , have been reported in up to 80% of MPMs, and this mutation may be of diagnostic utility (4,5). The tumor suppressor neurofibromin 2 is encoded by the NF2 gene, located on chromosome 22q12. Mutations in NF2 are found in ~40% of MPMs, and heterozygous loss of NF2 is identified in ~74% of MPMs (6,7). Mutations are rare in the TP53 and RAS genes, which are frequently present in epithelial solid tumors (8,9). Epigenetic alterations, such as DNA methylation, have been found in MPMs, which have a different profile compared with lung cancer (10-12). MPMs, particularly of the epithelioid subtype, may be hard to differentiate from adenocarcinoma arising in the lung periphery, and epidemiological evidence indicates that asbestos and smoking are shared risk factors for these diseases (2,13,14). Currently, the differential diagnosis of MM is based on a range of morphological analyses, including a combination of histological and immunohistochemical staining, and electron microscopy (13,15,16).Cytogenetic studies have been performed on MPMs and adenocarcinomas arising in the lung periphery, however, no chromosomal aberra...